| NPI | 1487731055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC 1274) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810002025) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |